The aim of the present biomechanical study was to evaluate the stability of a novel simple and cost-effective mini-open double cow-hitch suture button technique of acromioclavicular (AC) joint stabilization in comparison to a well-established double tight-rope technique.
A total of 12 fresh-frozen cadaveric shoulders were randomized into two treatment groups. In either a coracoclavicular stabilization with a standard double tight-rope technique (Group 1; n?=?6, age 78years?±?10) or a double cow-hitch with two No. 5 FiberWire strains looped in a bicortical button placed at the bottom of the coracoid process (Group 2; n?=?6, age 80years?±?13). Both techniques were equally augmented with an AC joint cerclage using a FiberTape. All shoulders were tested in a servo-hydraulic material testing machine for elongation/cyclic displacement (in mm) after cyclic loading (70N cyclical load, 1500 cycles), stiffness (N/mm) and ultimate load to failure (N). The mechanism of failure was recorded. All tests were performed ibreak-through (n?=?3) and clavicular fractures medially at the fixation site (n?=?2) in group 2.
Stabilization of the AC joint with a novel mini-open double cow-hitch suture button technique resulted in a similar low elongation, high stiffness and ultimate load to failure compared to a double tight-rope technique. This cost-effective technique for AC joint stabilization could demonstrate a sufficient biomechanical stability with especially high stiffness and load-to-failure.
Biomechanical study.
Biomechanical study.Early data suggests that endoscopic ultrasound-guided gastroenterostomy (EUS-GE) is a safe and efficacious option for gastric outlet obstruction (GOO). However, there is a scarcity of data comparing outcomes with open gastrojejunostomy (OGJ).
Single-center retrospective cohort study of adult patients hospitalized with GOO who underwent EUS-GE or OGJ between January 1, 2014 and February 28, 2020. Primary outcomes were technical and clinical success.
Sixty-six patients were included of which 40 (60.0%) underwent EUS-GE and 26 (40.0%) underwent OGJ. Baseline characteristics were similar with respect to age (70.5 vs 69.7, p?=?0.81), sex (42.5% vs 42.3% female, p?=?0.99), median length of follow-up (98.0 vs 166.5days, p?=?0.8), prior failed intervention for GOO (22.5% vs 26.9%, p?=?0.68), and the presence of altered anatomy (12.5% vs 30.8%, p?=?0.07) between EUS-GE and OGJ, respectively. Technical success was achieved in 37 (92.5%) of EUS-GE and 26 (100%) of OGJ patients (p?=?0.15). EUS-GE was associated witour results.
There were no significant differences in technical or clinical success, symptom recurrence, reintervention, 30-day readmission, or 30-day mortality between EUS-GE and OGJ. EUS-GE patients experienced shorter delays to resumption of oral intake and chemotherapy, had shorter lengths of stay, and reduced hospital costs. Further prospective comparative studies are warranted to verify our results.One-anastomosis gastric bypass (OAGB) is an effective bariatric procedure that confers satisfactory weight loss and improvement in comorbidities. The present study aimed to compare OAGB with fixed bypass of the proximal 200cm of small bowel and tailored bypass of the proximal 1/3 of bowel.
Patients with class II/III obesity underwent OAGB with either fixed bypass of the proximal two meters or tailored bypass of the proximal 1/3 of bowel. The main outcomes of the study were weight loss, improvement in comorbidities, complications, and changes in nutritional parameters after each technique.
The present study included 80 patients (62 female) of a mean age of 41years and mean body mass index (BMI) of 50.9kg/m. The tailored bypass group was followed by a significantly lower BMI and significantly higher excess weight loss and total weight loss at 6 and 12months postoperatively. There was no significant difference between the two groups in terms of improvement in comorbidities. The fixed bypass group was associated with a significantly higher complication rate than the tailored bypass group (22.5 vs. https://www.selleckchem.com/products/kt-474.html 5%, P?=?0.04). Both groups were associated with similar changes in the nutritional parameters at 12months postoperatively, except for the higher serum albumin levels after the tailored bypass than the fixed bypass.
OAGB with tailored bypass of the proximal one-third of bowel was associated with greater weight loss and comparable improvement in comorbidities as compared to fixed bypass of the proximal two meters of intestine.
OAGB with tailored bypass of the proximal one-third of bowel was associated with greater weight loss and comparable improvement in comorbidities as compared to fixed bypass of the proximal two meters of intestine.Initial stability of uncemented acetabular components in total hip arthroplasty (THA) is important for osseointegration and potentially enhanced by screw fixation. We used Australian Orthopaedic Association National Joint Replacement Registry data to determine whether screw usage influences uncemented acetabular component survival.
Primary THA with uncemented acetabular components performed for osteoarthritis from 1999 to 2018 was included. Survivorship was calculated using Kaplan-Meier estimates of cumulative percent revision (CPR). Comparisons used Cox proportional hazards method. An instrumental variable analysis adjusted for surgeon preference for screws as a confounding factor was used.
Three hundred thirty thousand one hundred ninety-two THAs were included (31.8% with screws, 68.2% without). Two hundred twenty thousand six hundred seven were included in the instrumental variable analysis. Revision rate of acetabular components (all causes) was higher with screws during the first six years (hazard ratio (HR)?=?1.45 (95% CI 1.34, 1.57), p?&lt;?0.001) and lower thereafter (HR?=?0.81 (95% CI 0.67, 0.98), p?=?0.027). Revision rate of acetabular components for loosening was higher with screws over the entire study period (HR?=?1.73 (95% CI 1.51, 1.98), p?&lt;?0.001). Overall THA revision rate was higher with screws during the first six years (HR?=?1.20 (95% CI 1.15, 1.26), p?&lt;?0.001) but lower thereafter (HR?=?0.89 (95% CI 0.81, 0.98), p?=?0.020). Revision rate for dislocation was higher with screws over the entire period (HR?=?1.16 (95% CI 1.06, 1.26), p?&lt;?0.001). Instrumental variable analysis revealed higher revision rates with acetabular screws in the first six years. (HR?=?1.18 (95% CI 1.09-1.29), p?&lt;?0.001).
Screws did not confer a protective effect against acetabular loosening and were not associated with long-term negative consequences.
Screws did not confer a protective effect against acetabular loosening and were not associated with long-term negative consequences.